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    Substance abuse is a challenging obstacle to overcome in any circumstance, but the pandemic has been a particularly difficult and stressful situation for those who struggle. After so many months of uncertainty, fear, and isolation, “COVID fatigue” has begun to take a significant toll. Substance use is one way individuals attempt to cope.


    Other factors also contribute. The political climate, conflicts at home, boredom from not being able to go anywhere or do anything, relationship woes—all are reasons people turn to alcohol and drugs. And, the way social media has “normalized” substance use doesn’t help.


    “There are countless memes about white wine in the morning and drinking while you're on a FaceTime or a Zoom call; students pulling pranks and being stoned in the background. And that's funny. But it does serve to normalize this incidental time in our culture's history around opportunities for substance use—during what typically have been incompatible activities,” states Dr. Chad Sanders, Neuropsychologist with Palouse Psychiatry and Behavioral Health at Pullman Regional Hospital.



    Beware of Operant Conditioning


    One trend that really took hold during stay-at-home directives is delivery services—something that won’t likely cease when the pandemic eases up. Dr. Sanders says this could be dangerous territory for substance use, citing the phenomenon of operant conditioning which involves associating and reinforcing rewards.


    “It's hard for most other things to compete with the inherent reward of a substance. It's immediate, it's fast, it's strong, and it's easy. Basic operant conditioning says any behavior is going to increase with reward, especially if there's no competition. So, when you're at home and there's not anything else to do, an immediate, quick, easy buzz is going to become appealing. And the more you do it, the more it becomes conditioned,” he explains.


    Environment is also a component of this conditioning. For example, if substance use is distributed across a variety of environments—a friend’s house on Friday night, out bowling or to the movies, dinners—the diversity and frequency don’t typically become associated with drinking. But, if you are using substances regularly at home, you start to condition that environment with substance use.


    The same goes for smoking. “Most people smoke in the same place; a certain chair, porch, backyard. When you do that over and over again, that location, that stimuli, becomes associated with reward. Over time, that location and the objects there start to prompt the urge to use substances,” notes Dr. Sanders.



    Strategies to Overcome Substance Abuse


    One common way to try to curb substance use is to implement “discipline.” For instance, if you typically have a couple of drinks when you get home from work, you may say to yourself, “Tonight, I’m not going to drink until dinner.” Unfortunately, that approach actually tends to further reinforce the behavior.


    Better strategies include stimulus control and reward. With stimulus control, Dr. Sanders encourages deconditioning the environment. “One of the basic parts of stimulus control is get rid of substances; sterilize the environment. If you don't have anything in your house, it's not going to be as much about discipline versus the steps you'll have to take to go and get a substance. And that sometimes can be your saving grace,” he shares.


    Additional ideas to overcome substance abuse include:

    • Change up your routine. Move furniture around, don’t go straight to the kitchen when getting home from work, etc.
    • Try to visit as many different environments as you can. With COVID, that’s been more difficult. But something like camping or even a weekend away at a hotel can be doable.
    • Embed activities in your environment that are incompatible with substance use, such as exercise or meditation.
    • Incorporate “competition” by finding activities that will ultimately be more rewarding than using.
    • Avoid procrastination, which has been identified as a form of anxiety and which may lead to using substances to cope.
    • Enlist social support, even inviting trusted individuals to be a “gatekeeper.” This involves understanding that negative consequences will likely occur at some point.

    If everything else fails, Dr. Sanders proposes getting help via medications.


    “If the basic things aren't working for you, go nuclear. Don't focus on one thing at a time to make it work. Do it all. See your primary care provider, go to a therapist. Hit the gym. Enlist a social support army. All that stuff. The more things you can do to increase the likelihood of success, the more successful you'll be.”



    Visit Palouse Psychiatry & Behavioral Health






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